# BETH LAUREN HEANEY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1801236039
- **Gender:** F
- **Credential:** NURSE PRACTITIONER

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 209012405 | IL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 402869 | NY | — |

## Other

- **Enumeration date:** 07/02/2013
- **Last updated:** 07/03/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 209012405 | LICENSE NUMBER | IL |
| 05 | — | 370966854006 | — | IL |
| 05 | — | 370966854023 | — | IL |